2025 Overnight Summer Camp

Please complete the form below to complete your registration.

•  June 24 - 28

  Natchez Trace State Park

  22390 Natchez Trace Rd.

  Wildersville, TN 38351

  
  

  There are THREE steps to completing your registration.

  1) THIS PAGE - Child's Information

  2) CHECKOUT PAGE - Payment Options

  3) MEMBERSHIP - Parent's Information & Signatures

   
  

   
  

  A note to parents:

  Our overnight taekwondo camp is a great opportunity for your child!  If your child has no experience with sleep-away camps, this camp is ideal!  With its close proximity to Memphis, the fact that your child's taekwondo instructors are present, and the non-stop activities & fun, your child will have a great time and beg to come back next year!

   
  

  Who can go to overnight taekwondo camp?

  Any child between the ages of 5 and 14.  Black belts age 15 & over may apply to be a junior counselor.  It is not required that the child be a taekwondo student!  Any child who is not a student at Midtown Taekwondo or Hernando Taekwondo must be invited by a current student.

  
   
  What do we do at overnight camp?

  Since this is a taekwondo camp, we will do taekwondo, of course!  There will be several workouts throughout the week which will include patterns, sparring, and board breaking!  There are also a lot of fun activities as well. 

   
  

  
  What about safety at overnight camp?

  We have an excellent safety record.  The adult to child ratio is at most 1 counselor to every 12 campers.  All counselors are certified in CPR and First Aid.  Park rangers are also on patrol 24 hours per day.
  

   
  
  Cost: 

  $475.00 per child.  This includes: lodging in air-conditioned cabins, three meals per day at the on-site cafeteria, taekwondo training throughout the week, non-stop activities & tons of fun!

  • A deposit of $200 will secure your child's spot.  Deposits are non-refundable and non-transferable.
  • You may choose to pay the deposit only or pay in full.  If you choose to pay the $200 deposit, the remaining balance will be automatically charged to your card on file one week before the first day of camp.
  • Children on a waiting list will have their deposit refunded if no spots become available.
  • We have to meet a minimum number of campers by April 15th.  If we do not meet this number, campers will have their deposit refunded or credited to their account.
    
  
• Camper's First Name

  Camper's Last Name
  

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• Camper's Age:

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• Camper's Birthday
  

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• Camper's Gender MaleFemaleOther
  

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• Camper's Weight

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• Please list any allergies to food, insects, or medicine:

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• No child is allowed to have any medicine (prescription, over-the-counter, inhalers, etc.) in their possession at camp.  Please list ALL necessary medications and the instructions for administering them below. You will have an opportunity to give the medication to camp staff at check in.

  
• Please list all necessary medications and instructions for administering:
  

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• Is there anything else we need to know to care for this child?

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• Mom/Guardian's First Name

  Mom/Guardian's Last Name
  

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• Mom/Guardian's Mobile Phone
  

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• Mom/Guardian's Work Phone

  Work Extension
  

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• Mom's Email Address

  

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• Dad/Guardian's First Name

  Dad/Guardian's Last Name
  

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• Dad/Guardian's Mobile Phone
  

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• Dad/Guardian's Work Phone

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• Dad/Guardian's Email Address
  

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  Make Required

• Permission to Pick Up/Emergency Contact - The child will ONLY be released to the custodial parent/legal guardian or authorized person(s) listed below. Please list anyone outside of a parent/guardian who is authorized to remove the child from the facility or should be contacted in an emergency if the parents/guardian cannot be reached.

  
• Emergency Contact's Name

  Emergency Contact's Phone
  

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• 2nd Emergency Contact's Name

  2nd Emergency Contact's Phone
  

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• Release for Emergency Care:

  In the comment box below, please provide the following information:

  1) Pediatrician Name and Phone Number

  2) Preferred Hospital

  3) Insurance company covering child and Insured's Name

  4) Policy number

  5) Group number

  
• Please list medical information for emergency care:
  

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• In some instances, camp staff may need to administer over the counter medications such as Tylenol, Benadryl, Pepto-Bismol, and Neosporin.  Dosage will be administered to your child as described on the packaging unless otherwise noted by the parent below.  If you have any concerns, or do not want your child taking certain medications, please list them below and speak with an instructor.

  
• Special concerns regarding over the counter medication:

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• I give Midtown Taekwondo staff members permission to contact the physician listed above in case of emergency if I/we cannot be reached. I give my consent to any emergency facility and physician to administer necessary treatment to my child(ren) in the event of an emergency at which time I cannot be reached. I give consent to transport by ambulance if the situation warrants it.

  Yes; I agree to the emergency consent listed above

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  Yes; I agree to the emergency consent listed above
• Photo Waiver: MTKD will occasionally take pictures of children in the program to send to parents, post on social media, or use in marketing material. I give Midtown Taekwondo the right to publish pictures of my child/children and/or myself. I understand that these pictures may be printed, placed on the Midtown Taekwondo website, or incorporated into promotional material such as brochures and videos. I also understand the circulation of the materials could be worldwide and that there will be no compensation to me for this use.

  Yes; I give permission to use any and all photographs taken for posting on social media and/or printed materials.

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  Yes; I give permission to use any and all photographs taken for posting on social media and/or printed materials.

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